The Role of Pharmacists in Sleep Health: a Screening, Awareness and Monitoring Program

Project Details
Project ID: IIG-043
Type: Investigator Initiated
Status: Completed
Institution: University of Sydney
Chief Investigator: Dr Bandana Saini

Project Summary

Objective: To develop, implement and evaluate an innovative primary care model in community pharmacy for screening, monitoring and education of people with sleep disorders (SD) and those at future risk of developing them.

Methods: A screening tool combining validated instruments for individual SD such as obstructive sleep apnoea (OSA), restless legs syndrome (RLS) and insomnia as well as known risk factors related to various SD was developed and pilot tested (5 conveniently selected pharmacies, 81 patients). Pharmacists from 23 pharmacies were trained to conduct a sleep health awareness campaign whilst recruiting patients over a 4 month period. Pharmacies were randomised into the basic arm (risk assessment only (RAO)) or comprehensive arm (risk assessment plus overnight nasal flow monitoring (FlowWizard®), (RA+)). Patients deemed at risk for a SD were counselled and if necessary referred to a GP.

Results: Twenty pharmacies completed the study recruiting a total of 295 patients (RAO n =131, RA+ n =164). Of these, 25% (RAO 19%, RA+ 29%) had an increased risk of daytime sleepiness, 28% (RAO 23%, RA+ 31%) were at risk of significant insomnia, 43% (RAO 37%, RA+ 47%) at risk of OSA, and 37% (RAO 34%, RA+ 38%) at risk of RLS. 20% of the screened population were at risk of having or developing one sleep disorder, 13% two SD, and 2% all three SD. Pharmacists delivered 754 intervention to screened patients and made 94 referrals. In a follow up (n=126), 29 of those screened took up referrals and 24% of these were diagnosed with a sleep condition (3=OSA, 2=RLS, 1=insomnia); a further 24% are awaiting sleep tests.

Conclusion: This primary care model has the capacity to improve detection and management of people at risk of having or developing SD. This model also has the capacity to enhance the contribution of community pharmacies in the care of patients with SD.